In the past, ilio-lumbar fixation has been attempted by (a) the Magerl method in which external fixator pins are applied from behind to transfix the posterior mass of each ilium and other pins transfix the pedicles of a lumbar vertebrae, these fixators then being connected by an external frame, but this method has a very limited application and has not been generally adopted; (b) the Galveston method in which rods affixed to the spine by various means are passed through or into the posterior iliac mass from medial to lateral, being used mainly for very extensive corrections of spinal deformity when there is a need to fix the lumbo-sacral segment, affording limited stability to this segment in the saggital plane but only very poor stability in the coronal plane and rotation.
Many methods also exist that attempt to achieve direct lumbo-sacral fixation, i.e. between the lowest lumbar vertebrae and the sacrum, all of which use some form of screw fixation into the sacrum itself, but there is a danger of damaging nerves in or exiting from the sacrum, and the poor mechanical quality of sacral bone makes the strength of the screw fixation to the sacrum unpredictable.